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  • 1.
    Alkner, Björn
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Orthopaedics, Eksjö, Region Jönköping County, Linköping, Sweden.
    Bring, Daniel K- I
    Division of Orthopedics and Biotechnology, Clintec, Karolinska Institutet, Stockholm, Sweden.
    Muscle Activation During Gravity-Independent Resistance Exercise Compared to Common Exercises2019In: Aerospace Medicine and Human Performance, ISSN 2375-6314, E-ISSN 2375-6322, Vol. 90, no 6, p. 506-512Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The aim was to study quadriceps muscle activation during resistance exercise using a flywheel device, developed as a gravity-independent resistance exercise device to be used during spaceflight, compared with traditional strength training exercises. METHODS: Eight healthy men experienced in resistance exercise performed the following exercises in random order: flywheel leg press (FW), knee extension isokinetic dynamometry (ID), barbell front squat (FS), weight stack leg press (LP), and weight stack knee extension (KE). They accomplished eight repetitions of coupled concentric and eccentric actions with simultaneous recordings of surface electromyography (EMG) from the three superficial quadriceps muscles and knee angles using electrogoniometry. Maximal voluntary contraction (MVC) in knee extension was performed before and after these measurements. RESULTS: EMG averaged across muscles and angles and normalized to MVC was 99/76% in FW, 48/41% FS, 65/47% LP, 81/52% KE, and 93/84% ID in concentric/eccentric phases, respectively. FW and ID showed higher mean EMG activity than LP and FS concentrically and higher than all other exercises eccentrically. No difference in activity between FW and ID was found. Pre- and post-MVC torque was comparable. DISCUSSION: Quadriceps muscle activation was superior in FW and ID exercises compared to the other exercises. The difference was most pronounced in the eccentric phase, but even concentric activation was lower in traditional closed chain exercises. This data supports that FW is an effective training tool and should be considered when designing strength training programs for spaceflights and on Earth.

  • 2.
    Alkner, Björn
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Orthopaedics, Eksjö, Region Jönköping County, Sweden.
    Halvardsson, Christina
    Falun Cent Hosp, Sweden.
    Brakenhielm, Gustaf
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Department of Orthopaedics, Eksjö, Region Jönköping County, Sweden.
    Eskilsson, Therese
    Falun Cent Hosp, Sweden.
    Andersson, Erika
    Falun Cent Hosp, Sweden.
    Fritzell, Peter
    Falun and Futurum Acad Hlth and Care, Sweden.
    Effect of postoperative pneumatic compression after volar plate fixation of distal radial fractures: a randomized controlled trial2018In: Journal of Hand Surgery, European Volume, ISSN 1753-1934, E-ISSN 2043-6289, Vol. 43, no 8, p. 825-831Article in journal (Refereed)
    Abstract [en]

    We investigated the difference between postoperative rehabilitation with or without adjunctive intermittent pneumatic compression therapy following distal radial fracture treated with volar plating. A total of 115 patients were randomized to a control or to an experimental group. After 4 weeks of immobilization the experimental group received intermittent pneumatic compression therapy in addition to conventional postoperative rehabilitation. Primary outcome up to 1 year postoperatively was assessed using the Canadian Occupational Performance Measure. No significant differences between groups were found. There were no clinically relevant differences regarding the secondary outcome measures swelling, strength, pain and flexibility. We conclude that postoperative intermittent pneumatic compression treatment had no major benefits. The results of the present study do not support general use of intermittent pneumatic compression initiated 4 weeks following volar plating surgery for distal radial fracture. Level of evidence: I

  • 3.
    Nilsson, Abraham
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Alkner, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Orthopedics, Regional Hospital Eksjö, Region Jönköping County, Sweden.
    Wetterlöv, Patrick
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Department of Orthopedics, Regional Hospital Eksjö, Region Jönköping County, Sweden.
    Wetterstad, Stefan
    Department of Orthopedics, Region Hospital Kalmar, Kalmar, Sweden.
    Palm, Lars
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Schilcher, Jörg
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Low compartment pressure and myoglobin levels in tibial fractures with suspected acute compartment syndrome.2019In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 20, no 1, article id 15Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The intense ischemic pain of acute compartment syndrome can be difficult to discriminate from the pain related to an associated fracture. Lacking objective measures, the decision to perform fasciotomy is often only based on clinical findings and performed at a low threshold. Biomarkers of muscle cell damage might help to identify and monitor patients at risk. In patients with fractures, however, markers of muscle cell damage could be elevated because of other reasons associated with the trauma, which would make interpretation difficult. In a review of all patients who underwent emergency fasciotomy in our health care district we aimed to investigate the decision-making process and specifically the use of biomarkers in patients with and without fractures.

    METHODS: In the southeast health care region of Sweden 79 patients (60 men) with fractures (median age 26 years) and 42 patients (34 men) without associated fractures (median age 44 years) were treated with emergency fasciotomy of the lower leg between 2007 and 2016. Differences in clinical findings, p-myoglobin and p-creatine phosphokinase as well as pressure measurements were investigated.

    RESULTS: P-myoglobin was analyzed preoperatively in 20% of all cases and p-creatine phosphokinase in 8%. Preoperative levels of p-myoglobin were lower in patients with fractures (median 1065 μg/L, range 200-3700 μg/L) compared with those without fractures (median 7450 μg/L, range 29-31,000 μg/L), p < 0.05. Preoperative intracompartmental pressure was lower in the fracture group (median 45 mmHg, range 25-90 mmHg) compared with those without fractures (median 83 mmHg, range 18-130 mmHg), p < 0.05.

    CONCLUSIONS: Biomarkers are seldom used in the context of acute fasciotomy of the lower leg. Contrary to our expectations, preoperative levels of p-myoglobin and intracompartmental pressures were lower in fracture patients. These findings support differences in the underlying pathomechanism between the groups and indicate that biomarkers of muscle cell necrosis might play a more important role in the diagnosis of acute compartment syndrome than previously thought.

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  • 4.
    Svedman, Simon
    et al.
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Alkner, Björn
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Orthopaedics, Eksjö, Region Jönköping County, Sweden.
    Berg, Hans E.
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Domeij-Arverud, Erica
    Karolinska Inst, Sweden.
    Jonsson, Kenneth
    Uppsala Univ Hosp, Sweden.
    Helander, Katarina Nilsson
    Sahlgrens Univ Hosp, Sweden.
    Ackermann, Paul W.
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    STOP leg clots - Swedish multicentre trial of outpatient prevention of leg clots: study protocol for a randomised controlled trial on the efficacy of intermittent pneumatic compression on venous thromboembolism in lower leg immobilised patients2021In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 5, article id e044103Article in journal (Refereed)
    Abstract [en]

    Introduction Leg immobilisation in a cast or an orthosis after lower limb injuries is associated with a high risk of complications of venous thromboembolism (VTE) and hampered healing. Current pharmacoprophylaxes of VTE are inefficient and associated with adverse events. Intermittent pneumatic compression (IPC) could represent a novel, efficient and safe VTE-prophylactic alternative that may enhance injury healing. The aim of STOP leg clots is to assess the efficacy of adjuvant IPC-therapy on reduction of VTE incidence and improvement of healing in lower leg immobilised outpatients. Methods and analysis STOP leg clots is a multicentre randomised controlled superiority trial. Eligible patients (700 patients/arm) with either an acute ankle fracture or Achilles tendon rupture will be randomised to either addition of IPC during lower-leg immobilisation or to treatment-as-usual. The primary outcome will be the total VTE incidence, that is, symptomatic and asymptomatic deep venous thrombosis (DVT) or symptomatic pulmonary embolism (PE), during the leg immobilisation period, approximately 6-8 weeks. DVT incidence will be assessed by screening whole leg compression duplex ultrasound at removal of leg immobilisation and/or clinically diagnosed within the time of immobilisation. Symptomatic PE will be verified by CT. Secondary outcomes will include patient-reported outcome using validated questionnaires, healing evaluated by measurements of tendon callus production and changes in VTE-prophylactic mechanisms assessed by blood flow and fibrinolysis. Data analyses will be blinded and based on the intention-to-treat. Ethics and dissemination Ethical approval was obtained by the ethical review board in Stockholm, Sweden, Dnr 2016/1573-31. The study will be conducted in accordance with the Helsinki declaration. The results of the study will be disseminated in peer-reviewed international journals.

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  • 5.
    Svegard, Johannes
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Department of Orthopaedics, Region Jönköping County, Sweden.
    Nordvall Persson, Astrid
    Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Rehabilitation Centre, Eksjö, Region Jönköping County, Sweden.
    Zetterlund, Christina
    Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Rehabilitation Centre, Eksjö, Region Jönköping County, Sweden.
    Alkner, Björn
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Orthopaedics, Region Jönköping County, Sweden.
    Comparison of use of plaster casting versus elastic bandage following carpal tunnel release: a randomized controlled study2021In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 53, no 3, article id jrm00168Article in journal (Refereed)
    Abstract [en]

    Objective: To compare the effects of two postoperative regimens following carpal tunnel release; plaster casting and elastic bandaging.Design: A randomized controlled study.

    Patients: Patients with carpal tunnel syndrome and planned surgical carpal tunnel release were invited to participate.Methods: A total of 94 patients were randomized to either plaster casting or elastic bandaging to be used 2 weeks postoperatively. Muscle strength, pain rated on a visual analogue scale, range of movement, sensibility, oedema, and different scores regarding symptoms and function were measured before and 2, 4, 6, 8 and 26 weeks after surgery.

    Results: No differences were found between the 2 groups for any measurement, except for the DASH (Disability of the Arm, Shoulder and Hand) Health Score and daily function, rated 2 weeks postoperatively, in which the bandage group scored better. Both groups improved significantly over time for all measurements, sensibility was improved after 2 weeks, while strength was not fully recovered until week 26.

    Conclusion: Following carpal tunnel release no benefits were found in using plaster casting, compared with elastic bandaging. Among these patients there was more discomfort during plaster casting compared with elastic bandaging; therefore plaster casting is not recommended following this type of surgery.

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1 - 5 of 5
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